• J Card Surg · Jul 2010

    Comparative Study

    Symptomatic young infants with tetralogy of fallot: one-stage versus staged repair.

    • Chun Soo Park, Woong-Han Kim, Gi-Beom Kim, Eun Jung Bae, Jin-Tae Kim, Jeong Ryul Lee, and Yong Jin Kim.
    • Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon, Korea.
    • J Card Surg. 2010 Jul 1;25(4):394-9.

    Background And Aim Of The StudyDebate continues over the optimal timing for total repair of tetralogy of Fallot. Here, we report our experience with early one-stage total repair of tetralogy of Fallot.MethodsBetween January 2000 and March 2008, surgical treatment was required in 24 symptomatic patients who were diagnosed with tetralogy of Fallot at less than three months of age. Among them, total repair was performed in 13 patients (group 1) and initial palliation was done in the others (group 2). The median follow-up duration was 20 months (5 to 40 months) and 67 months (1 to 100 months) in each group.ResultsThere was one operative death in group 2. The duration of mechanical ventilatory support, and the lengths of intensive care unit stay and hospital stay were not statistically different between both groups. The ventricular septal defects were repaired through the right atrium in 12 patients (12/13, 92.3%) of group 1 and nine patients (9/11, 81.8%) of group 2 (p = 0.576). Transannular repair was performed in six patients (6/13, 46.2%) of group 1 and 10 patients (10/11, 90.9%) of group 2 (p = 0.036). Reintervention or reoperation was required in two patients of group 1 and three of group 2 (p = 0.630). During follow-up, the pulmonary arterial growth was more prominent in group 1.ConclusionsEarly one-stage total repair of tetralogy of Fallot can be performed safely without increasing the risk for reoperation or reintervention, in the short term. The pulmonary annulus is likely to be preserved when it is repaired at an early age. Early total repair may be better for the pulmonary arterial growth than staged repair.

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